Healthcare Provider Details

I. General information

NPI: 1720617541
Provider Name (Legal Business Name): ELIZABETH NICOLE KLEIN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8930 W SUNSET RD STE 300
LAS VEGAS NV
89148-5013
US

IV. Provider business mailing address

680 PILOT RD STE B1
LAS VEGAS NV
89119-9015
US

V. Phone/Fax

Practice location:
  • Phone: 702-258-7788
  • Fax:
Mailing address:
  • Phone: 702-258-7788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDO4120
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: